PT  - JOURNAL ARTICLE
AU  - Kwizera, Arthur
AU  - Kabatoro, Daphne
AU  - Owachi, Darius
AU  - Kansiime, Jackson
AU  - Kateregga, George
AU  - Nanyunja, Doreen
AU  - Sendagire, Cornelius
AU  - Nyakato, Doreen
AU  - Olaro, Charles
AU  - Audureau, Etienne
AU  - Mekontso Dessap, Armand
TI  - Respiratory support with standard low-flow oxygen therapy, high-flow oxygen therapy or continuous positive airway pressure in adults with acute hypoxaemic respiratory failure in a resource-limited setting: protocol for a randomised, open-label, clinical trial – the Acute Respiratory Intervention StudiEs in Africa (ARISE-AFRICA) study
AID  - 10.1136/bmjopen-2023-082223
DP  - 2024 Jun 01
TA  - BMJ Open
PG  - e082223
VI  - 14
IP  - 6
4099  - http://bmjopen.bmj.com/content/14/6/e082223.short
4100  - http://bmjopen.bmj.com/content/14/6/e082223.full
SO  - BMJ Open2024 Jun 01; 14
AB  - Rationale Acute hypoxaemic respiratory failure (AHRF) is associated with high mortality in sub-Saharan Africa. This is at least in part due to critical care-related resource constraints including limited access to invasive mechanical ventilation and/or highly skilled acute care workers. Continuous positive airway pressure (CPAP) and high-flow oxygen by nasal cannula (HFNC) may prove useful to reduce intubation, and therefore, improve survival outcomes among critically ill patients, particularly in resource-limited settings, but data in such settings are lacking. The aim of this study is to determine whether CPAP or HFNC as compared with standard oxygen therapy, could reduce mortality among adults presenting with AHRF in a resource-limited setting.Methods This is a prospective, multicentre, randomised, controlled, stepped wedge trial, in which patients presenting with AHRF in Uganda will be randomly assigned to standard oxygen therapy delivered through a face mask, HFNC oxygen or CPAP. The primary outcome is all-cause mortality at 28 days. Secondary outcomes include the number of patients with criteria for intubation at day 7, the number of patients intubated at day 28, ventilator-free days at day 28 and tolerance of each respiratory support.Ethics and dissemination The study has obtained ethical approval from the Research and Ethics Committee, School of Biomedical Sciences, College of Health Sciences, Makerere University as well as the Uganda National Council for Science and Technology. Patients will be included after informed consent. The results will be submitted for publication in peer-reviewed journals.Trial registration number NCT04693403.Protocol version 8 September 2023; version 5.